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依维莫司是一种口服的雷帕霉素抑制剂,已经被批准用于多种实体瘤的治疗,但是部分患者在使用依维莫司后出现了高血糖的不良反应。在这篇系统评价中,我们将评估使用依维莫司的患者高血糖的发生率及相对风险。全面检索Cochrane Library,Pub Med,EMBASE数据库及国际顶尖会议(AACR,ASCO,和ESMO)的会议摘要,纳入2014年11月之前发表的随机对照试验(RCT)。总共有来自8个RCT的3377名患者(依维莫司组:1971,对照组:1406)被纳入系统评价。在依维莫司组,所有级别高血糖的发生率为20.0%(95%CI:11.0%–29.0%),高级别(3–4级)高血糖的发生率为6.0%(95%CI:3.0%–8.0%)。依维莫司组所有级别高血糖的发生率是对照组的2.94倍(95%CI:2.34–3.70),依维莫司组高级别高血糖的发生率是对照组的4.66倍(95%CI:2.75–7.89)。依维莫司可显著增加高血糖的发生风险,且风险与肿瘤类型和依维莫司的剂量相关。
Everolimus, an oral rapamycin inhibitor, has been approved for treatment of a variety of solid tumors, but some patients experience adverse reactions to hyperglycemia after using everolimus. In this review, we will assess the incidence and relative risk of hyperglycemia in patients who have used everolimus. A comprehensive summary of the proceedings of the Cochrane Library, Pub Med, EMBASE database and top international conferences (AACR, ASCO, and ESMO) was included in the RCT published before November 2014. A total of 3377 patients (everolimus group: 1971, control group: 1406) from 8 RCTs were included in the systematic review. In the everolimus group, the overall incidence of hyperglycemia was 20.0% (95% CI: 11.0% -29.0%) and high grade (grade 3-4) hyperglycemia was 6.0% (95% CI: 3.0% -8.0%). The incidence of all-grade hyperglycemia in everolimus-treated patients was 2.94-fold (95% CI: 2.34-3.70) in the control group and 4.66-fold higher in the everolimus-treated patients (95% CI : 2.75-7.89). Everolimus significantly increased the risk of developing hyperglycemia and the risk correlated with tumor type and everolimus dose.